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Dr KK Aggarwal

From the Desk of Editor in Chief
Padma Shri and Dr B C Roy National Awardee

Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist and Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04); Editor in Chief IJCP Group of Publications & Hony. Visiting Professor (Clinical Research) DIPSAR

  Editorial ...

17th October 2010, Sunday

For regular emedinews updates follow at www.twitter.com/DrKKAggarwal

eMedinewS wishes all its readers a very happy Dusshera. On this day of Dusshera let us kill Tamas (Kumbhakaran), Rajas (Meghnatha) and Ego (Ravana) within us.

Hands–only CPR gives better survival than conventional CPR

According to a study in JAMA, cardiac arrest victims have a 70% greater chance of survival if CPR is administered by using only hand compressions rather than by using compressions and mouth–to–mouth. According to the American Heart Association less than one–third of those patients receive CPR from bystanders. Most are hesitant about offering mouth–to–mouth resuscitation. Also, a rapid deterioration of blood flow occurs during even brief disruptions of chest pumping, the long ramp–up time for resumption of normal flow when compressions are begun again after a pause, the significant amount of time necessary to perform breathing, and the critical importance of keeping blood flow to the brain going during a heart attack. Moreover, most heart attack victims gasp for air every 15 to 20 seconds, and that provides more oxygen than mouth–to–mouth. Standard CPR and compression–only CPR are currently considered equivalent by the American Heart Association.

For professionals, though, conventional CPR will continue to have a place, because airway ventilation is important for some victims of cardiac arrest. This JAMA study follows two studies in the New England Journal of Medicine that found chest compression-only CPR is at least as effective as the traditional method.

Dr KK Aggarwal
Editor in Chief
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  Chikungunya Update

(R. P. Vashist, Consultant and Head Public Health, Government of Delhi)

What is Chikungunya?
Chikungunya, in the Makonde language means "that leans downward". is a viral illness with symptoms similar to dengue fever manifesting with an acute febrile phase of the illness lasting only two to five days, followed by a prolonged arthralgic disease that affects the joints of the extremities.


  • Fund CHIKV Fever
  • Buggy Creek virus infection
  • Knuckle fever
  • Me Tri virus infection
  • Semliki Forest virus infection
  Photo Feature (from the HCFI Photo Gallery)

World Heart Day 2007

A special “Simplicity Walk” was organized by Heart Care Foundation of India and Philips Electronics India to mark World Heart Day in 2007. The walk was flagged off jointly by Delhi Health Minister Yoganand Shastri and Chitrashi Rawat, Vidya Malvade and Shilpa Shukla (Actors of ‘Chak De India’ fame). They led the walk for a distance of 5 km.
In the photo: Sagarika Ghatge, Chitrashi Rawat and Shilpa Shukla, Padma Shri & Dr BC Roy National Awardee Dr KK Aggarwal, President HCFI at the ‘Simplicity Walk’.

Dr K K Aggarwal
  IMSA Update

International Medical Science Academy (IMSA) Update

Exercise blood pressure and cardiovascular outcome

A study in more than 4800 asymptomatic normotensive individuals found that a hypertensive response to treadmill testing was associated with an increased risk for cardiovascular death.

(Ref: Weiss SA, et al. Exercise blood pressure and future cardiovascular death in asymptomatic individuals. Circulation 2010 May 18;121(19):2109–16).

  National News

IMA Election (for a CHANGE)

Emedinews requests all its readers to support our editor Dr. K.K. Aggarwal, Padma Shri and Dr. B C Roy National Awardee who is contesting for the post of Vice President of the National Indian Medical Association (IMA). Members of Central Council of IMA, Working Committee Members, Presidents and Secretaries of IMA in addition to all office bearers are the voters in this election. Dr. Aggarwal is well–known for his work in the field of academics.

Warning against breast cancer

Doctors in the Capital have warned that the number of deaths due to breast cancer has gone up. Going by statistics, at the current rate of increase breast cancer will have overtaken cervical cancer by the year 2020. October is observed as national breast cancer awareness month. In the Capital, 3,000 women get breast cancer every year while 1,000 women die of breast cancer. Doctors, however, state that the cure rate of over 98 per cent is expected in the early stages of breast cancer if detected and treated. (Source: The Hindu)

Stop Desai from holding WMA post, PM urged

Hyderabad: Medical fraternity from across the state has made a joint appeal to Prime Minister Manmohan Singh to stop the former Medical Council of India (MCI) chairman Dr. Ketan Desai from taking charge as the president- elect of the World Medical Association (WMA) and put him behind bars. While the CBI investigation is still on and the chargesheet under process, the tainted former chairman has been granted bail and has been allowed to go to WMA Vancouver in Canada, to take charge as its president for 2010–11. (Source: Indian Express)

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology

Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

  International News

(Dr.G.M. Singh)

Become Breast Self Aware

Early detection is the best defense against breast cancer. The steps involved in self exam are:

  • Place yourself in front of a mirror with breasts exposed.
  • Place your hands on your hips.
  • Look for signs of swelling, dimpling, redness or soreness in all parts of your breasts in the mirror.
  • Do the same with your arms raised above your head.
  • While still standing, feel for lumps by applying gentle pressure to your breasts with your fingers. Use a larger area of your fingers rather than prodding. Feel the area just beneath the skin as well as the tissue deeper within.
  • Go over the entire breast while examining. A useful method is the ‘circular method.’ Start from the nipple and move out around the breast being aware of lumps or other irregularities. Also, examine the "axillary tail" of each breast that points towards the axilla (armpit).
  • Repeat the process while lying down.
  • Check the nipples and the area just beneath them. Gently squeeze each nipple to check for any discharge.

(Dr Monica and Brahm Vasudev)

Manufacturer voluntarily withdraws Meridia due to risk for heart attack and stroke

Abbott Laboratories, maker of sibutramine, agreed to voluntarily withdraw the obesity drug from the market because it might place users at increased risk of heart attack and stroke, according to an Oct. 8 announcement from the U.S. FDA. The agency requested the action following review of data from a trial of about 10,000 patients –– randomized to sibutramine or placebo over 60 months –– initiated to examine the cardiovascular safety of the drug, which was approved for weight loss by the FDA in November 1997. The Sibutramine Cardiovascular Outcomes Trial (SCOUT) showed a 16 % increase in risk of major adverse cardiovascular events in patients taking the drug compared to placebo recipients. Weight loss in the treatment group was relatively modest, and the FDA concluded that the risks associated with the drug outweighed its potential to help patients lose weight.

Omeprazole linked to fewer gastrointestinal events in patients on dual antiplatelet therapy

Omeprazole may be associated with a lower risk of upper gastrointestinal bleeding in patients taking aspirin and clopidogrel, without a significant increase in risk of cardiovascular events, according to research published online Oct. 6 in the New England Journal of Medicine. Deepak L. Bhatt, M.D., of the Veterans Affairs Boston Healthcare System, and colleagues analyzed data from 3,761 adults with an indication for dual antiplatelet therapy who were randomized to receive clopidogrel with either omeprazole or placebo, in addition to aspirin.

Rolofylline not helpful in acute heart failure patients

The adenosine A1– receptor antagonist rolofylline does not appear beneficial in treating acute heart failure patients with renal dysfunction, according to research published in the Oct. 7 issue of the New England Journal of Medicine.

HRT increases CHD risk in women with metabolic syndrome

A new research presented at the 21st Annual Meeting of the North American Menopause Society (NAMS) states that HRT increased the risk for coronary heart disease (CHD) in women who had metabolic syndrome at the time of starting therapy by 29%; but, it had no effect on CHD risk in women without metabolic syndrome.

  Hepatology Update

Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta – The Medicity

What causes biliary atresia?

The cause of biliary atresia has not yet been discovered. The disease affects approximately one infant in every 20,000 live births. Girls are affected slightly more often than boys, but no racial or ethnic group appears to be more affected than any other. Fischler et al reported cytomegalovirus (CMV) infection in almost 25% of affected infants based on immunoglobulin M (IgM) serology, in their study. Chang et al have reported an even higher frequency of CMV infection in cases of idiopathic neonatal hepatitis, lending support to the concept that both disorders are ends of the same pathological spectrum, originally described by Landing as infantile obstructive cholangiopathy. Reovirus and rotavirus are other viruses that may be associated though further studies need to be done.
Various genetic abnormalities, including deletion of the mouse c-jun gene (a proto-oncogene transcription factor) and mutations of homeobox transcription factor genes are associated with hepatic and splenic defects; however, a direct link to biliary atresia has not been described.
Other factors like environmental toxins and disordered immunologic mechanisms have also been linked but still further studies are required.
  Infertility Update

Dr. Kaberi Banerjee, Infertility and IVF Specialist Max Hospital; Director Precious Baby Foundation

Is infertility a common problem?

Yes. About 10 % of women (6.1 million) in the United States aged 15–44 have difficulty getting pregnant or staying pregnant, according to the Centers for Disease Control and Prevention (CDC).

  Cardio Update: Question of the Day

What is the value of plasma renin activity in a hypertensive? (Sukumar Mukherjee, Ajoy Biswas)

The renin angiotensin system plays an important role in salt and water homeostasis and blood pressure regulation. Angiotensin II causes peripheral vasoconstriction, increased cardiac contractility, facilitation of presynaptic norepinephrine release, stimulation of thirst and long-term proliferative effect on vasculature, heart and renal mesangium through its interaction with various growth factors. It causes direct renal vasoconstriction, augmentation of tubuloglomerular feedback sensitivity and stimulation of proximal and distal tubular sodium reabsorption rate.

(Ref: Navar LG. The kidney in blood pressure regulation and development of hypertension. Med Clin North America 1997;81:1165–98)

  Medicolegal Update

Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS

All legal formalities in hospital stand suspended till lifesaving medical care is completed

In an emergency, the first priority of a doctor is to save the health, limb and life of the patient by applying all possible medical/surgical available interventions to keep the patient out of danger. All legal formalities stand suspended till this is achieved. This has been clearly exemplified by the Hon’ble Supreme Court of India in Parmananda KataraVs Union of India: "Every doctor is bound to provide medical aid to the victims irrespective of the cause of injury; he cannot take any excuse of allowing law to take its course".

MCI in an affidavit in the same case said that the registered medical practitioners must attend to the sick and the injured immediately and it is the duty of the medical practitioner to make immediate and timely medical care available to every injured person, whether he is injured in an accident or otherwise……Life of a person is far more important than the legal formalities. The justified delay due to medical/surgical/resuscitative reason cannot be treated as an intentional delay for legal perusal.

  Medi Finance Update


One can invest in mutual funds, debt funds and GILTS (Govt. Securities) funds. Never keep your money in the savings accounts. The yield is only 3% and with an inflation of 5%, you ultimately lose money. There are new generation income funds, look for them.

  Drug Update

List of drugs prohibited for manufacture and sale through gazette notifications under Section 26a of Drugs & Cosmetics Act 1940 by the Ministry of Health and Family Welfare

  Drugs prohibited from the date of notification

  Tetracycline Liquid Oral preparations

  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Indirect Antiglobulin Test

  • Also known as IAT; Indirect Coomb’s test; Antibody screen; Indirect Anti–human globulin test
  • To detect antibodies directed against red blood cell antigens, in preparation for a blood transfusion, or during pregnancy and at delivery.
  IJCP Special

Dr Good Dr Bad

Situation: A patient was found to have high ESR with normal CRP.
Dr. Bad: The lab report is wrong.
Dr. Good: We need to rule out SLE.
Lesson: Raised ESR together with a normal C–reactive protein (CRP) is often a false positive value for the ESR; but, these findings can also be observed in acute SLE (systemic lupus erythematosus).

Make Sure

Situation: A patient with acute heart attack died on the way to the hospital.
Reaction: Oh my God! Why was the patient not accompanied by the doctor?
Lesson: Make sure that all heart attack patients are accompanied by the doctor to the hospital so that chest compression (CPR) can be given if the heart stops on the way.

Quote of the Day (Dr.G M Singh)
"Sow an act, and you reap a habit; sow a habit, and you reap a character; sow a character, and you reap a destiny." George Dana Boardman

  Mind Teaser

Read this…………………

a home home

Answer for yesterday’s eQuiz: "The correct answer is B. CT scan of the abdomen."
CT scan is the most appropriate NEXT step in ruling out distant metastases in this patient with a new diagnosis of gastric malignancy who presented with weight loss and hepatomegaly. Ultrasound would help assess the depth of invasion that a CT cannot accurately determine, especially in early cases, but will not detect distant metastasis. Testing for H. pylori and its eradication are recommended for patients with early disease and not those with advanced disease. It is not the next best test anyway. Positron emission tomography (PET) will help evaluate suspicious but indeterminate lesions seen on CT imaging.

Correct answers received from: Dr. Parvesh Sablok, Dr. Manjesha

Answer for 15th October Mind Teaser is: "Splitting hairs"
Correct answers received from: Dr. B.V.Sai Chandran, Dr Anupam Sethi Malhotra, Dr Sukanta Sen, Dr Vijay Kansal, Dr.G.Padmanabhan, Dr Jainendra Upadhyay, Dr Meera Rekhari

Send your answer to ijcp12@gmail.com

  Humor Section

Joke (Dr G M Singh)
What is the difference between a psychiatrist and a psychologist?
If you say to a psychiatrist, "I hate my mother," he will ask, "Why do you say that?"
While a psychologist will say, "Thank you for sharing that with us."

  An Inspirational Story

The Glass of Milk

One day, a poor boy who was selling goods from door to door to pay his way through school, found he had only one thin dime left, and he was hungry. He decided he would ask for a meal at the next house. However, he lost his nerve when a lovely young woman opened the door. Instead of a meal he asked for a drink of water. She thought he looked hungry so brought him a large glass of milk. He drank it slowly, and then asked, "How much do I owe you?"

"You don’t owe me anything," she replied. "Mother has taught us never to accept pay for a kindness." He said…… "Then I thank you from my heart." As Howard Kelly left that house, he not only felt stronger physically, but his faith in God and man was strong also. He had been ready to give up and quit.

Year’s later that young woman became critically ill. The local doctors were baffled. They finally sent her to the big city, where they called in specialists to study her rare disease. Dr. Howard Kelly was called in for the consultation. When he heard the name of the town she came from, a strange light filled his eyes. Immediately he rose and went down the hall of the hospital to her room.

Dressed in his doctor’s gown he went in to see her. He recognized her at once. He went back to the consultation room determined to do his best to save her life. From that day he gave special attention to the case. After a long struggle, the battle was won. Dr. Kelly requested the business office to pass the final bill to him for approval.

He looked at it, and then wrote something on the edge and the bill was sent to her room. She feared to open it, for she was sure it would take the rest of her life to pay for it all. Finally she looked, and something caught her attention on the side of the bill.

She read these words……"Paid in full with one glass of milk"

Tears of joy flooded her eyes as her happy heart prayed: "Thank You, God, that Your love has spread abroad through human hearts and hands."

  Readers Responses
  1. Dear Sir, You are really doing a wonderful and commendable job which is benefiting so many doctors.Hats-off to you Sir. Please keep it up. Dr. Manjesha, Manjesh Hospital, Kalluvathukkal, Kerala.
  Public Forum

(Press Release for use by the newspapers)

What’s Behind My Low Blood Pressure?

There is nothing like low blood pressure. If it is low keep it low and it is good for the heart said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President, Heart Care Foundation of India and MTNL Perfect Health Mela. People can get their Blood Pressure checked free of cost at the 17th MTNL Perfect Health Mela which is being held from 23-31st October 2010 at NDMC Ground, Laxmi Bai Nagar, New Delhi.

Most people worry about high blood pressure and how to bring it under control but low blood pressure can also be a medical problem, in the following medical circumstances.

Heart Care Foundation of India lists common causes of low blood pressure (medically called hypotension):

  • A side effect of drugs, such as certain antidepressants, diuretics, painkillers or heart medicines
  • Alcohol use
  • Heart failure or heart attack
  • Dehydration
  • Severe allergic reaction (anaphylaxis)
  • Advanced diabetes
  • Going into shock
  • Irregular heartbeat (arrhythmia)
  Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

17th MTNL Perfect Health Mela 2010 Events: Venue: NDMC Ground Laxmi Bai Nagar, New Delhi

24th October, Sunday: Perfect Health Darbar, Interaction with top Medical experts of the city from 8 AM to 5 PM
30th October, Saturday: eMedinewS Update from 8 AM to 5 PM
29th October, Friday: Divya Jyoti Inter Nursing College/ School Competitions/ Culture Hungama
30th October, Saturday: Medico Masti Inter Medical College Cultural festival from 4 PM to 10 PM
31st October, 2010, Sunday: Perfect Health Darbar, An interaction with top Cardiologists

Dr. Sood Nasal Research Foundation Announces

Rhinology Update 11th to 15th November
22nd National Endoscopic Sinus Surgery Course on 11th & 12th November, 2010 2010 at Dr. Shroff’s Eye & ENT Hospital, New Delhi
Cadaveric Sessions on 13th November, 2010 at Lady Hardinge Medical College.
33rd All India Rhinoplasty Course, on 14th & 15th November, 2010, at Metro Hospital, Preet Vihar, Vikas Marg, New Delhi.

For information contact: Dr. V P Sood, Course Chairman, Ear, Nose & Throat Center, 212, Aditya Arcade, 30, Community Center, Preet Vihar, Vikas Marg, Delhi–110092 (India). Tel: 011–22440011, 42420429. E–mail:drvpsood@gmail.com,vpsood@drsoodnasalfoundation.com
Website: www.drsoodnasalfoundation.com

eMedinews Revisiting 2010

The 2nd eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 2, 2011. The event will have a day–long CME, Doctor of the Year awards, Cultural Hungama and Live Webcast. Suggestions are invited.

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